Abstract: Objective To explore the clinical application of free and pedicled skin flaps in the repair of lower leg skin defects. Methods A retrospective analysis of 110 cases of lower leg skin defects repaired by skin flap from September 2017 to September 2020 were conducted. According to the type of skin flap, the patients were divided into a free group and a pedicled group. The intraoperative and postoperative conditions of the patients were analyzed respectively to understand the difference between the two groups of patients after receiving treatment. Results The operation time of the free group was longer than that of the pedicled group by more than 5 h, and the amount of intraoperative blood loss was more than that of the pedicled group （P<0.05）. In addition, the incidence rate of postoperative contractures in the free group was higher than that in the pedicled group, and the difference between the groups was statistically significant （P<0.05）. At the same time, the postoperative sensory recovery in the treated area of the lower leg was good in the two groups, with no big deviation. It could be seen from the survival curve that the flap survival rates of the two groups of patients were high, and the survival rate of the pedicled group was slightly higher than that of the free group. Conclusion Both flap repairing methods for lower leg skin defects are effective. Free flap is more adaptable, while pedicled flap is more manipulative and more effective.

Key words: Surgical flap repair, Leg skin defect, Free flap, Pedicled flap